there is loss of memory and paralysis of other muscles. But as the hour is up I will simply speak of Cuprum for cramps, chorea and convulsion and Phos. for brain fag. Our next drug will be Sepia. MINERALS. LOCATION.—SENSATIONS.— MODALITIES.— THERAPEUTICAL APPLICATION. SIMPLE. Calc.-Bone, muscles, connective tissue. Ferrum.-Blood. Kali.-Blood and all protoplasm. Mag.-Nerve and blood. Nat.-All tissues. Phos.-Bone. Silica.-Cartilage, bone. Sulph.-Skin, protoplasm. COMPOUND. Calc. phos.-Bone cells, muscle cells, nerve cells, brain cells. Calc. fluor.-Bone cells. Calc. sulph. Ferrum phos.-Hair, crystalline lens, nerve cells, muscle cells. Kali phos. Kali mur.-Muscle cells. Mag. mur.-Nerve cells, bone cells, muscle cells. Nat. mur.-All solids, all liquids, muscle cells, nerve cells, mucus. LOCATION. BLOOD. Fer.-Prevents oxydation. Decreases red blood cells. Causes profound anæmia. Merc.-Decreases red blood cells. Increases white blood cells. Coagu lates albumen. Prevents digestion of fats. Prevents proper oxydation. Kali.-Destroys coagulability. Causes loss of albumen. Causes loss of fibrin. Causes degeneration of red blood cells. BRAIN AND NERVES. Arg. nit.-Softening, paralysis. Cuprum.-Irritation, inflammation, paralysis. Plumbum.-Irritation of spinal cord (colic, constipation); interstitial inflammation, degeneration of tissues. Zinc.-Hyperæsthesia, paralysis, degeneration of cerebro-spinal. Plat.-Hyperæsthesia. Sulph.-Vitiated secretions. GLANDS. Merc.-Altered secretions, inflammation, suppuration. Hepar.-Inflammation, suppuration. Calc.-Chronic inflammation, altered secretions. MUCUS MEMBRANES. Alum.-Dryness, slight inflammation. Arg. nit.-Inflammation, ulceration, increased secretions. SKIN. Sulphur, Nat. mur., Hepar sulph., Antimonies, Arsenic.—Eczema. BONES AND CARTILAGES. Phos.--Inflammation, necrosis. Silicea.-Suppuration. Calc.-Defective growth. LUNGS. Phos.-Inflammation, croupous infiltration, hæmorrhages. LIVER. Phos.-Inflammation, fatty degeneration. KIDNEYS. Merc. cor.-Tube casts, inflammation, degeneration. Phos.-Fatty degeneration, inflammation, hæmorrhage. SENSATIONS. WEAKNESS. -Arsenicum, Ferrum, Stannum, Kalies. BURNING.—Ars., Phos., Arg. nit., Alum.; Caust., Merc., Silica, Zinc. CUTTING.-Kalies, Calc. c., Merc., Zinc. RAWNESS.-Caust., Arg. nit., Phos. JERKING.-Plat., Stannum, Caust., Kali c., Sil., Nat. mur. SORENESS AND BRUISED.-Hepar., Nat. mur., Sil., Stan., Merc., Plat. THROBBING.-Calc. c., Kali ., Alum., Sil. NUMBNESS.-Plat., Plumb., Zinc. MODALITIES. AGGRAVATION FROM COLD.—1. Kali carb., Calc. c., Arsenicum, Caust., Hepar., Am. carb., Aurum. 2. Baryta carb., Mag. carb., Sil., Merc., Graph. Nat. mur., Nat. AGGRAVATION BY MOTION.-I. Merc., Sil., Sul. 2. THERAPEUTICAL APPLICATION. HEADACHE -Fer, Kalies, Nat. mur., Phos., Sil., Sul., Plat., Plumb., EYE.-Arg. nit., Hepar., Merc., Kalies, Zinc., Caust., Sul. LIVER.—Merc., Hepar., Phos., Sil., Kali carb., Mag. mur. UTERINE AND OVARIAN.-Plat., Ars., Sulph., Fer., Alum., Phos., LUNGS.-Calc. c., Kali c., Phos., Iod. Lime, Ant. tart., Stannum, Sul, Sil SKIN.-Ars., Sul., Hepar., Sil., Ant. tart., Merc. MUCUS MEMBRANES.-Merc., Kalies, Alum., Arg. nit. BRAIN AND NERVES.—Arg. nit., Alum., Calc., Baryta, Zinc., Plumb., Merc., Cuprum, Phos. THE THERAPEUTICS OF HEART FAILURE.* BY GEORGE G. SHELTON, M.D. Professor of Materia Medica, New York Homoeopathic Medical College and Hospital, New York. IT T CAN safely be asserted that one-half of the drugs in our Materia Medica have more or less influence upon the heart; notwithstanding this fact, we can number upon our fingers the principal ones resorted to in cases of weak heart, or threatened heart failure. The purpose of this paper is to study the drugs most frequently used under these conditions; their physiological properties, and their homœopathic indications, and also, to make comparisons with others, not as frequently used, but which are equally effectual when properly administered. Incidentally, threatened heart failure is a disease that uniformly demands the most prompt and intelligent treatment. In all such cases, we are impelled by the severity of the conditions that confront us, to resort to heroic means; such as stimulants and cardiac tonics. Relying more upon the dose and force of the agent used, to do that which could be accomplished more easily and with greater certainty, if we did not allow our apprehension to take us away from our stronghold, the Similimum. I will at the outset recall a few of the methods commonly used; and which will, I think, cover the majority of the expedients that suggest themselves to us; I have placed them as near as I can in the order that they are popularly regarded as efficacious. * Read before the Homoeopathic Medical Society of the County of New York, 1895. First Stimulants (whiskey, brandy, etc.). This raises a mooted question. Experienced and conservative men are found in large numbers who conscientiously believe that all alcoholic stimulation is bad treatment. Others, equally well fortified by experience and observation, contend for their value. Both classes are to a certain extent extremists. I cannot accept either rule as an infallible guide, and yet I fully believe that many a feeble heart struggling along, has been startled into a spasmodic effort by the sudden administration of a half-ounce or ounce of whiskey or brandy that has soon caused it to cease altogether. Physiologically, alcohol in small doses stimulates the heart. The quick effect obtained, is due to its rapid diffusibility. It is thrown quickly into the circulation, arousing the entire system, as it were, from a species of physical apathy. It intensifies and increases, when administered in small doses, both the arterial pressure and the pulse rate. In increased doses, they become greatly depressed. The first, due to the action of the heart itself; the second, a vaso-motor paralysis, through its powerful action upon the nerve centers. As the usefulness of these agents depend entirely upon their strength, that is, the presence of alcohol, whiskey is preferred to brandy (I refer to American whiskey), as it contains from five to eight per cent. more alcohol. I am prepared, therefore, to take the middle ground in this controversy, and claim for stimulants a sphere of usefulness when properly administered. For example: In a threatened heart failure, due to organic cardiac disease, especially the forms that impair the muscular power of the heart, such as dilated or hypertrophied walls, that the sudden excitation induced by alcohol is attended with considerable risk. Also in cardiac disease, consequent upon or associated with serious lesions of the kidney, alcohol may become dangerous; but in a threatened failure due to a wasting disease, or more particularly a toxæmia, as for example diphtheria, alcohol in cautious doses should not be wholly interdicted by our school. Foremost among the drugs is the Foxglove, the Digitalis. Invaluable in some forms of weak heart, it becomes a source of great danger in others. In old school therapeutics it is resorted to more frequently than any other drug, and carelessly administered too frequently in our own. A brief study of its physiological properties will aid us when we compare it from a homoeopathic standpoint. its action upon the peripheral ends of the inhibitory nerves, as well as upon the cardiac muscle, it produces a veritable cardiac spasm. By It first prolongs the diastole, next, increases the power of the systole. In increased doses, and here I quote an eminent authority, "the systolic irritation overbalances the diastolic stimulation;" which, shorn of its technical phraseology, accounts for the irregu larity of the pulse beat, by the incomplete and irregular contraction and dilatation. One portion of the ventricle dilating, while the other is contracting; hence, the irregular, intermittent pulse. Clinically, from this standpoint, it is indicated in a heart relatively weak; that is, when the work demanded of the heart, is greater than its ability to perform; but by the peculiar action of the drug, its use in true hypertrophy is unsafe. In valvular lesions, where the hypertrophy is not compensatory, it may be used with caution. The Ammonias, either the hydrate, or the salt known as the Ammonium Carbonate, are resorted to frequently. The first, preferably by inhalation. They have, however, a transitory effect and are rapidly eliminated; and though unquestionably stimulating, are not resorted to in cardiac failure resulting from organic diseases, or prolonged illness, with as satisfactory results as other agents. Their sphere of usefulness being greater in sudden attacks of weakness, such as syncope, rather than from more serious causes. Of recent years, Trinitrin, our Glononin, has come into popularity; and certainly no more attractive theory for the use of a drug, than that given by Bartholow and others could be presented. That author claims for Glononin that it strengthens the cardiac energy, increases its contractile force, and at the same time dilates the arterioles; thus, not alone improving the power of the heart to supply blood, but also reducing the peripheral resistance; and in this manner taking away some of the strain upon that organ. Strophanthus, Convallaria, Galvanism; all have a limited sphere of usefulness. I will not, however, spend any more time in this physiological résumé of these popular remedies. My only purpose in having introduced it at all, was to show the limited resources at the command of our friends of the other school; and to aid us in our study of some of the same drugs from a purely homoeopathic standpoint by thus recalling their peculiar properties. It is self-evident that we may expect a certain group of symptoms to present themselves in cases of heart failure; and we find with equal certainty a similar uniformity in the symptoms expressed by drugs, applicable to that disease. Thus establishing another of those striking truths, i. e., the perfect harmony that exists between the symptomatic and the pathological. There are a few general |